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Dir GBD Special Programs in Woodbridge Township, NJ at Anthem, Inc.

Date Posted: 9/13/2018

Job Snapshot

Job Description

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Responsible for the fiscal and operational management/implementation and oversight of a special product/programs such as long term service and supports (LTSS), Primary duties may include, but are not limited to:
•         Develops and implements the strategic vision, goals, objectives, policies and decision making for the special product/program organization.
•          Oversees all health plan medical management programs including concurrent review, pre-certification, discharge planning, case management, disease management, provider profiling, quality management, accreditation, health promotion and outreach.
•          Facilitates and collaborates with medical management staff to identify gaps and improve processes.
•          Oversees the design and development of provider contracts and partnerships to achieve quality, cost management, and strategic business development objectives; develops and negotiates strategic provider contracts on behalf of the Plan.
•         Leads the performance management/earnings improvement activities for the special product/program organization.
•          Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Oversees a large staff both internally and field based staff

Will have P&L responsibilities.
Requires a BA/BS; 10+ years of relevant experience, including prior management experience in a managed care setting with operations, budgeting and forecasting, process improvement, or planning experience; or any combination of education and experience, which would provide an equivalent background. MPA, MPH, MSN or MBA with Health Care concentration preferred. RN or LMSW license preferred.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran.